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The CMS Proposed Rule for 2018 Quality Reporting

The much-anticipated proposed rule for quality reporting in 2018 has been released by CMS. This proposal aims to grant clinicians greater flexibility to promote participation in the Quality Payment Program (QPP). The following details are regarding the MIPS year 2 reporting.

The most noteworthy pieces of the proposal include:

Low Volume Threshold for the Reporting Year 2018

• Clinicians or groups who bill $90,000 or less Medicare Part B OR
• Clinicians or groups who provide care for 200 or fewer Medicare Part B beneficiaries

2018 Reporting Period

The quality performance category (CQM) reporting period will be the calendar year 2018. Clinicians will need to report on 50% of their patients, regardless of the payer to meet the completeness threshold. The recommended number of CQMs to report remains six.

The advancing care information and improvement activity categories will have reporting periods of a minimum of any continuous 90 days in 2018. Where previously a practice needed to report using EHR solutions certified to the 2015 Edition certification, this proposed rule grants clinicians the flexibility to use EHR technology certified to either the 2014 or 2015 Edition criteria during the 2018 reporting period.

MIPS Final Score

The proposal includes a change to the 2018 weight of each category in the MIPS final score.

Quality

60%

Cost

0%

Improvement Activities

15%

Advancing Care Information

25%

Bonus Opportunities

Complex Patient Bonus - 1 to 3 bonus points are proposed to be awarded to clinicians based on the medical complexity of the patients they treat.

Small Practice Bonus – The proposal includes a 5 point bonus to those practices with 15 or fewer clinicians, as long as they submit data on at least 1 performance category.

Using 2015 Certified EHR Technology – Those clinicians that use 2015 Edition Certified EHR for their entire reporting period will be granted 10 bonus points.

We at eMDs are excited about the additional flexibility afforded to all practices looking to participate in quality reporting, and we will continue to monitor CMS’s proposal and its impact as we move forward to 2018. For additional information on quality reporting, visit the CMS website at cms.gov.